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128 Cards in this Set
- Front
- Back
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What two hormones are released from the posterior pituitary?
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Oxytocin and ADH
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What is the target organ and role of Oxytocin?
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-mammary glands and uterus
-mild ejection and childbirth |
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What is the target organ and role of ADH?
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-kidney
-water retention |
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What hormes are released from the anterior pituitary?
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-ACTH and TSH
-FSH and LH -Prolactin -Growth Hormone |
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What are the target organs and roles of ACTH and TSH?
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-adrenal cortex and thyroid
-secretion and growth of glands |
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What are the target organs and roles of FSH and LH?
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-ovaries and testes
-secretion of hormones, growth of sex glands, and reproductive functions |
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What is the target organ and role of prolactin?
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-mammary glands
-milk production |
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What is the target organ and role of growth hormone?
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-most tissues
-body growth |
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What hormones are released from the thyroid?
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Thyroid hormones and cacitonin
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What are the target organs and role of thyroid hormones?
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-most tissues
-control metabolic rate |
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What is the target organ and role of parathyroid hormone (PTH)?
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-bone and kidney
-removes Ca from bone and raises bone Ca |
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The optic chiasm lies _______ and _______ to the pituitary gland and is compressed by what that cause visual field defects?
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-anterior and superior
-anterior pituatary neoplasms |
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A pituitary tumor should be considered in any patient that presents with what?
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visual field changes and severe headaches
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What is released from the adrenal cortex?
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-cortisol
-androgens -aldosterone |
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What is the target organ and role of aldosterone?
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-kidney
-Na retention |
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What is the target organ and role of androgens?
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-many tissues
-male sex characteristics |
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What is the target organ and role of cortisol?
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-many tissues
-resistance to stress |
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What is released from the adrenal medulla?
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epinephrine
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What is the target organ and role of epinephrine?
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-many organs
-fight of flight reaction |
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What hormones are released from the pancreas?
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insulin
glucagon |
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What is the target organ and role of insulin?
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-muslce, fat, liver
-reduces blood glucose |
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What is the target organ and role of glucagon?
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-liver
-raises blood glucose |
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What is the target organ and role of activated vit. D?
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intestines, bones, and kidneys
-raises blood Ca |
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What is the target organ and role of erythropoietin?
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-bone marrow
-increases red blood cells |
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What are 4 characterisitcs of water soluble hormones?
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-occur in very low blood concentrations
-blood concentrations can change rapidly -there are no normal values -have short half lives |
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______ soluble hormones have predictable blood concentrations and long half lives.
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fat soluble
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It is hard to get hypoCa w/out what underlying disease?
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renal failure
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You really only have to worry about plasma calcium when what happens?
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when albumin is low
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What 2 signs can mean hypocalcemia?
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-Chvostek's
-Trousseau's |
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_______ is important in bone remodeling and in the tx of osteoporosis.
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calcitonin
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There is an inverse relationship between calcitonin and what?
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PTH
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Aldosterone is what?
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a mineralocorticoid
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Aldosterone acts on intracellular mineralocortocoid receptor in the ____ ______ tubule to promote sodium moving into the blood and potassium out to the urine
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distal renal
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Addison's is hypofunction of what?
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adrenal cortex
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In Addison's disease there is an increase in ____ and a decrease in _____
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-increase in K
-decrease in Na |
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Primary of Aldosteronism is the opposite of what dx?
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opposite of Addison's
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In Primary Aldosteronism there is a increase in _____ and decrease in ____/
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-increase in Na
-decrease in K |
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What does HARPS stand for in primary Aldosteronism
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H-HTN
A-Aldosterone is raised R-renin is lowered P-potassium is decreased S-sodium raised |
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The structure of oxytocin is similiar to what?
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ADH
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Suckling on the breast causes a release of what?
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oxytocin
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What is the hormone that keeps you calm in stressful situations?
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oxytocin
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Prolactin is similiar to what other hormone?
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GH
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Exercise, fasting and stress leads to an increased secretion of hGH and prolactin, which means what?
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-hGH-rise in blood glucose
-prolactin-infertility |
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Lactating breast leads to secretion of prolactin, which means what?
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infertility and milk synthesis
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There is a relationship between prolactin and what?
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dopamine
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Amiodarone can cause what?
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hyperthroidism and pulmonary fibrosis
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What are some S and S of Grave's Disease?
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-clubbing
-fine tremor -moist palms -tachycardia -a fib -proximal myopathy -pre-tibial myoxedema |
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_____ changes T3 to T4.
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tyrosine
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T4 can change to T3 where?
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peripherally
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Why do you have to measure free T4?
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b/c it is the active part
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What 4 things make of the thyroid eye disease?
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1-edema (periorbital and chemosis)
2-proptosis 3-retraction 4-ophthalmoplegia (upgaze palsy) |
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In hyperthyroidism, what does the TSH and T4 do?
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-TSH is decreased
-T4 is increased |
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What are some S and S for hypthyroidism?
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-amenorrhea
-bradycardia -constipation -reduced appetite -sensitive to cold weather -lethargic -dry skin, loss of hair -gruff voice -coarse facial hair -goiter -myxedema may occur |
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For hypothyroidism what happens to TSH and T4?
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-TSH is increased
-T4 is decreased |
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Reflexes are what in hypothyroidism?
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deminished
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What is the opposite of growth hromone?
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somatostatin
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Acromegaly and diabetes mellitus are commonly seen with what disease?
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giantism, excessive secretion of growth hormone
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The pituiatary tumor that causes the excessive hGH secretion often causes what?
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bitemporal hemianopia thru pressure on the optic chiasm
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What are some facial characteristics seen in acromegaly?
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-prominant supraorbital ridges
-check for bitemporal hemianopia -big ears -big nose -bid lips and tongue -check neck for JVP and goiter |
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What are the ABCDEF's of acromegaly?
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A-arthropathy
B-BP C-carpal tunnel syndrome D-diabetes E-enlarged tongue, heart, thyroid F-fields, bitemporal hemianopia |
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What are some characteristics of Prognathism associated with acromegaly?
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-protrution of jaw
-separation of teeth -malocclusion -underbite -reversal of normal overbite |
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Confirmation of acromegaly is the failure to do what during a glucose tolerance test?
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failure of suppression of GH during glucose tolerance test
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What is the MCC of adrenal cirsis?
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stopping steroids suddenly
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Adrenal crises are precipitated in pts with Addison's disease by what 4 things?
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-surgery/anesthetics
-serious injuries -diarrhea -serious infections |
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Shaehan's is post partum infarction of the pituitary that causes what?
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Addison's
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Adrenal crisis is characterized by what 2 main things?
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1-sudden drop in BP
2-sometimes hypoglycemia |
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Cortisol migh possibly be needed for the normal transcription/translation of the genes which code for what 3 things?
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1-vasopressin (ADH) receptors
2-angiotensin II receptors 3-alpha adrenergic receptors |
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Cushing's disease is the opposite of what other disease?
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Addison's
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What are the altered appearances that can happen in Cushing's?
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-central obesity
-moon facies -plethora of the face -acne -red-purple stretch marks of the skin of the abdomen |
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What are some mood changes associated with Cushing's Disease?
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-depression
-lethargy -decreased ability to concentrate |
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What are some muscle changes associated with Cushing's?
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-atrophy
-muscle weakness |
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What are some other things that can happen in Cushing's that haven't been mentioned yet?
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-osteoporosis
-immunosuppresion -high BP -DM |
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What are some screening tools for Cushing's?
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-24 urine cortisol level
-loss diurnal rhythm -low dose dexamethasone test DO NOT get a serum cortisol because it will tell you nothing |
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What are some causes of Cushing's?
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-exogenous steroids
-Pituitary adenoma -adrenal adenoma or carcinoma -ectopic ACTH syndrome |
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Insulin and glucagon communicate via what?
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hexokinase
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Insulin stimulates lipogensis and ihibits what?
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proteolysis in the liver
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Insulin lowers serum K concentrations how?
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by simulating increased uptake in muscle and adipose tissue
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The uptake of what is independent of insulin?
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uptake of glucose by the brian, erythrocytes, and liver
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Insulin stimulates what in muscle cells?
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amino acid uptake and protein synthesis in muscle cells
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Insulin does what in adipose cells?
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stimulates fatty acids and triglyceride synthesis and inhibits lipolysis in adiopose cells
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Glucagon stimulates what and promotes what?
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-stimulates hepatic glycogenolysis
-promotes gluconeogensis |
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Somatostatin inhibits the secretion of what?
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thyrotropin and GH
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Somatostatin inhibits the secretion of what in the pancreas?
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glucagon, insulin, and pancreatic polypepetide secretion in pancreas
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Somatostatin inhibits digestion by inhibiting secretion of ______, ____, and _______, as well as by decreasing gut blood flow and motility.
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-gut hormones
-gastric acid -pepsin |
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An increase in prolactin can cause what?
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amenorrhea
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After pregnancy, prolactin stimulates what?
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lactose synthesis
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How does the increase in prolactin cause amenorrhea during lactation?
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by suppressing LH
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ACTH stimulates cortisol release from where?
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adrenal cortex
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GH has an anabolic effect of skeletal and cardiac muslce leading to what?
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positive nitrogen balance
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GH has ________ effects.
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diabetogenic
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What does TSH do?
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stimulates the release of T3 and T4 from the thyroid
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ADH increases the permeability of renal collecting ducts to water, which leads to what?
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water reabsorption
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ADH decreases________ and increases ______ of urine.
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-decreases volume
-increases osmolarity of urine |
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ADH is released from the ______ _______ and is a potent what?
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-supraoptic nucleus
-vasoconstrictor |
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Oxytocin is released from the _____ _______.
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paraventricular nucleus
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ADH and oxytocin are what kind of hormones?
what does that mean? |
neural hormones
-secreted by neurons |
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Neural bodies reside in the supraoptic and paraventricular nuclei in the ___________, but the nerve endings that release the hormones are located where?
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-hypothalamus
-posterior lobe of the pituitary |
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PTH acts with calcitrol to do what?
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increase intestinal absorption of Ca and phosphate
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PTH stimulates absorption of Ca in the _____ nephron, but inhibits Ca absorption in the ______ tubule.
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-distal nephron
-proximal tubule |
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PTH inhibits phosphate reabsorption in the proximal tubules, leading to what?
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hypophosphatemia
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PTH increases cacitriol synthesis by stimulating what?
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1 alpha hydroxylase activity
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PTH increase renal excretion of what?
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Na, K, and HCO3
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Insulin is _____ soluble and absolutely essential for ____.
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-water
-life |
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What cells produce insulin?
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Beta cells
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What lab test can diagnose false hypoglycemia?
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C-peptide
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Free glucagon is important in what disease?
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diabetes
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Glucose and glucagon are what of each other?
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inverses
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Glucagon binding to its receptors increase what 3 things?
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1-blood glucose concentrations
2-plasma free fatty acid concentrations 3-plasma and urine ketone body concntration |
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Alpha cells in the pancreas secrete what?
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glucagon
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In DM 2, the most consistent abnormality seen in the pancreatic islets is the deposits of what?
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amyloid
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In diabetes, beta cells shrink in size in what disease?
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diabetes
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What is the major form of hemoglobin; a native unmodified tetramer consisting of two alpha and two beta chains.
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Hb A
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A general term for glucose bound nonenxymatically to hemoglobin, It has a ketoamine structure.
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Glycohemoglobin
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Glycohemoglobin species that are more negatively charged form of HbA, and include Hb A1a, Hb A1b, and HbA1c. They are detected by cation-exchange chromatographic and electrophoretic methods, and are also called the fast hemoglobins.
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HA1
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A specific glycohemoglobin that is an adduct of glucose attached to the beta chain valine residue. It is detected by cation-exchange chromotographic, electrophoretic, and immunoassay methods
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Hb A1c
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A term used to describe all glycohemoglobin species. It is measured by boronic acid affinity chromatographic methods.
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Total glycohemoglobin
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What are some S/E of Acarbose.
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gas, nausea, vomiting, etc and takes 6-12 months to get rid of it
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Acarbose lowers what?
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Glycemic index and post prandial sugars
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How are carbs stored in the body?
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as glycogen in the liver
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What is the number 1 cause of DKA?`
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infection, esp step pneumonia, and UTI
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What are some other causes/prcipitants of DKA
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-ischemia or infarction
-intra-abdominal -insulin deficiency -iagrogenic -alcohol/drug abuse, pancreatitis, trauma |
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How is DKA diagnosed?
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-anion gap metabolic acidosis (MUDPILES)
-+urine and serum ketones -high serum glucose, BUN, Cr, K -Pseudohyponatremia |
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What is the disease that is similiar to DKA that is usually seen in elderly type 2 diabetics?
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Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)
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What race does Ketosis-Prone Type 2 diabetes tend to affect?
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African Americans
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What does PANICS mean for DKA in the first hour?
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P-Potassium 20mmol if no peaked T
A-acidosis- N-NS 1liter in first hour, CVP I-Insulin; 6units stat then infuse 6u/hr C-catheter and cultures, urine, blood etc S-stomach aspiration, ET tube first if no gag reflex |
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What labs should be done in DKA?
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-BNP
-UA -CBC -CXR -ABG |
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WHat is the main determinant of pH in the body?
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ratio of bicarb to pCO2
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Acidosis may be primarlity caused by what?
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-respiratory problems (hypercapnia)
-or metabolic problems (lowering of bicarb) |
